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. 2020 Jan;17(1):35-42.
doi: 10.11909/j.issn.1671-5411.2020.01.006.

Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units

Victòria Lorente  1 , Jaime Aboal  2 , Cosme Garcia  3 , Jordi Sans-Roselló  4 , Antonia Sambola  5 , Rut Andrea  6 , Carlos Tomás  7 , Gil Bonet  8 , David Viñas  2 , Nabil El Ouaddi  3 , Santiago Montero  4 , Javier Cantalapiedra  5 , Margarida Pujol  6 , Isabel Hernández  7 , María Pérez-Rodriguez  8 , Isaac Llaó  1 , José C Sánchez-Salado  1 , Miquel Gual  1 , Albert Ariza-Solé  1
Affiliations

Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units

Victòria Lorente et al. J Geriatr Cardiol. 2020 Jan.

Abstract

Background: Little information exists about the role of anemia in patients with acute coronary syndromes (ACS) admitted to Intensive Cardiac Care Units (ICCU). The aim of this study was to assess the prevalence of anemia and its impact on management and outcomes in this clinical setting.

Methods: All consecutive patients admitted to eight different ICCUs with diagnosis of non-ST segment elevation ACS (NSTEACS) were prospectively included. Anemia was defined as hemoglobin < 130 g/L in men and < 120 g/L in women. The association between anemia and mortality or readmission at six months was assessed by the Cox regression method.

Results: A total of 629 patients were included. Mean age was 66.6 years. A total of 197 patients (31.3%) had anemia. Coronary angiography was performed in most patients (96.2%). Patients with anemia were significantly older, with a higher prevalence of comorbidities, poorer left ventricle ejection fraction and higher GRACE score values. Patients with anemia underwent less often coronary angiography, but underwent more often intraaortic counterpulsation, non-invasive mechanical ventilation and renal replacement therapies. Both ICCU and hospital stay were significantly longer in patients with anemia. Both the incidence of mortality (HR = 3.36, 95% CI: 1.43-7.85, P = 0.001) and the incidence of mortality/readmission were significantly higher in patients with anemia (HR = 2.80, 95% CI: 2.03-3.86, P = 0.001). After adjusting for confounders, the association between anemia and mortality/readmission remained significant (P = 0.031).

Conclusions: Almost one of three NSTEACS patients admitted to ICCU had anemia. Most patients underwent coronary angiography. Anemia was independently associated to poorer outcomes at 6 months.

Keywords: Acute coronary syndromes; Anemia; Intensive cardiac care units; Prognosis.

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Figures

Figure 1.
Figure 1.. Cumulative incidence of mortality (A) and mortality or readmission at 6 months (B) according to anemia status.
See this image and copyright information in PMC

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